Introduction
A group of chronic illnesses known together as chronic obstructive pulmonary disease (COPD) affect a person’s capacity to breathe normally. This presentation details a case study of a patient who visited the emergency room (ER) complaining of severe wheezing and shortness of breath. The diagnosis and treatment of COPD. The patient continues to have several other co-morbidities. He will need to take medicine to control both of these and his COPD over the long term. It is vitally advised that the patient follow their medicine schedule and alter their lifestyle. Patient education and evaluation procedures are included in nursing interventions to determine the best course of action for him. The patient has made some tiny strides and health markers have improved.
Situation
A patient with acute shortness of breath, frequent coughing, wheezing, and extreme exhaustion presented to the emergency room. It is a white male, 54 years old, who does not smoke. Although the patient has not been given a diagnosis, the ambulance gave him oxygen-fearing hypoxia. As this condition is a chronic obstructive lung disease, the nursing intervention should concentrate on evaluating and linking the symptoms to choose the most effective course of treatment.
Background detail
Chronic obstructive pulmonary disease (COPD) is a group of chronic inflammatory lung diseases that over time permanently clog the lungs’ airways (COPD). Elastic air sacs in a healthy person’s lungs allow them to breathe in air and exhale it by expanding and contracting respectively. With COPD, a variety of problems might restrict this motion and the airflow. Chronic bronchitis and emphysema are the two primary types of COPD. Emphysema causes damage to the airways and the walls of the air sacs (alveoli), making them less elastic. It is more difficult to expel carbon dioxide from the lungs because alveoli cannot rebound while exhaling since the fibers separating them have been destroyed. This leads to hypoxemia and hypercapnia when the disease develops (Loscalzo et al., 2022). The lining of the lungs is constantly inflamed and irritated, and chronic bronchitis causes an excessive amount of mucus to be produced. Exercise can cause breathlessness (dyspnea), which is caused by air getting stuck in the lungs as you exhale (Loscalzo et al., 2022). The airflow limitation is influenced by the fibrosis and inflammation of the airways as well as the presence of secretions like mucus.
The patient has a long history of eating disorders and is obese with a BMI of 36. He has made attempts to control his weight through diets and light exercise, but he does not experience sustained adherence. The patient was identified as having Type 2 diabetes about eight years ago, but he did not need insulin and was able to control his blood sugar levels using drugs like metformin. The patient’s total cholesterol level was 244, which was high. The patient takes Lisinopril once a day as directed to treat his or her intermittent complaints of elevated blood pressure. Additionally, the patient reported having varicose veins and showing symptoms of osteoporosis.
Clinical Assessment
Despite having been sitting for some time and relaxing, the patient is breathing heavily and making gasping noises. The patient seems a little pale and has blue tints on their lips; in addition to their oxygen saturation, they are given oxygen through a nasal cannula. The patient can move around and walk without help, but she complains of severe vertigo. The patient is trembling a little. The patient exhibits consciousness and stimuli-responsiveness. There were no other abnormalities found.
Recommendations
To boost the patient’s blood oxygen saturation over the recommended 90 percent range and stabilize it at a level of at least 88 percent, which is within typical ranges for COPD, oxygen was administered to the patient. An X-ray of the chest was taken to diagnose emphysema, the more common cause of COPD, and to rule out any other probable heart or lung conditions. Once the patient was stable, a lung pulmonary function test called spirometry was carried out to measure the amount of air that could be inhaled and exhaled to confirm COPD. In addition, the patient received a steroid to reduce inflammation and prevent infection as well as a short-acting bronchodilator to lessen coughing and shortness of breath.
First, the patient must be informed about their problem. Based on the symptoms, COPD may appear frightening and overpowering, but it can be controlled like other chronic diseases. It is essential to explain to the patient how each of his chronic diseases exacerbates the others. Only by making significant lifestyle changes and adhering to prescribed medications and treatment programs will the condition be effectively managed over the long term and flare-ups reduced.
Long-term adherence to treatment regimens and lifestyle changes are necessary for managing chronic disease. The patient should make an effort to manage his chronic diseases with the help of prescribed medication, which will probably continue because of his age and health, but also make an effort to prolong his life and improve his quality of life. From a nursing and provider standpoint, it is crucial to monitor, support and set reasonable, attainable goals for the patient and give the tools needed to reach them.
Two concepts—compliance and persistence—are essential to adherence to treatment and lifestyle recommendations. First, things need to be adhered to and performed consistently throughout time. Additionally, a system ought to assess and gauge adherence and identify what benefits the patient and what does not (López-Campos et al., 2019). Vogelmeier et al(2020).’s cyclical model of assessing symptoms, exacerbations, and mistakes discovered causes ranging from incorrect technique to mental anguish, and ultimately adjusted to create changes. The process is repeated until a system is identified that is most suitable for the patient and might guarantee long-term adherence and goal achievement.
Conclusion
COPD is the main nursing diagnosis; it is a chronic ailment that needs to be treated. Long-acting bronchodilators and steroid inhalation can be used to treat it. The goal of COPD treatment is to control symptoms and lower the chance of an exacerbation (Vogelmeier et al., 2020). Pharmaceutical and non-pharmaceutical approaches should be used to accomplish this. When there are additional co-morbidities present, COPD thrives. The severity of COPD is impacted by diabetes, high blood pressure, and high cholesterol levels. The patient’s weight, which is a result of his unhealthy lifestyle choices, is also a result of these diseases. Therefore, non-pharmaceutical weight loss strategies would enhance the diet and the standard of physical activity. Pharmaceutical interventions could potentially improve the condition concerning blood pressure, cholesterol, and blood sugar, which would have a cascade effect.
References
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Loscalzo, J., Fauci, A. S., Kasper, D. L., Hauser, S. L., Longo, D. L., & Jameson, J.L. (2022). Harrison’s principles of internal medicine (21st ed.). McGraw Hill.
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Vogelmeier, C. F., Román-Rodríguez, M., Singh, D., Han, M. K., Rodríguez-Roisin, R., & Ferguson, G. T. (2020). Goals of COPD treatment: Focus on symptoms and exacerbations. Respiratory Medicine, 166(1), 105938.